One major question that has loomed over Philadelphia’s support of opening the country’s first supervised injection facility has been who would assume the legal risk of the nonprofit overseeing the site in the face of aggressive threats from the Trump administration that it would shut down the enterprise?
The answer: Ed Rendell, former Pennsylvania governor and mayor of Philadelphia.
In an interview with WHYY Tuesday, Rendell said he has incorporated a nonprofit called Safehouse that will solicit private funding to support a space where those struggling with opioid addiction can use illegal drugs under the watch of medical professionals.
In August, Deputy Attorney General Rod Rosenstein told WHYY that if a supervised injection facility opens in Philadelphia, the response from federal authorities would be swift and aggressive.
Rendell says bring it.
“I’ve got a message for Mr. Rosenstein: I’m the incorporator of the safe injection site nonprofit, and my address is in the offices of the Bellevue,” he said. “They can come and arrest me first, because federal prisons are nicer than state prisons.”
In January, Philadelphia Mayor Jim Kenney announced that the city was encouraging private entities to step up to support such a facility, which advocates call an overdose prevention site. Last year, more than 1,200 people in Philadelphia died from drug overdoses, mostly from opioids. That is more than four times the city’s murder rate.
The supervised injection site is seen as an health-care entry point for opioid users and a possible link to treatment, but resistance from the Trump administration is strong.
“This can save lives. There’s no question about it,” Rendell said. “I think everybody involved in the program is ready to absorb the risk, myself included.”
Top city officials declined to comment initially. When Mayor Jim Kenney was asked about it at a news conference Wednesday, he responded “Our city solicitor would like us not to talk about it at the moment.” When pressed by reporters Kenney did say he favors creating a site where drug users can shoot up under medical supervision. He says he expects it to be somewhere in or near Kensington, but would not elaborate.
In 1992, when Rendell was Philadelphia mayor at the height of the AIDS crisis, he authorized a citywide clean needle-exchange program for drug users — despite threats from state and federal officials that authorities would shut down the operation.
Philadelphia poised to lead U.S.
Pennsylvania Department of State officials have approved the nonprofit’s application, which is now pending before the Internal Revenue Service for tax-exempt status. That process could take up to 18 months.
In addition to Rendell, Ronda Goldfein of the AIDS Law Project of Pennsylvania and Jose Benitez of Prevention Point are board members, according to the group’s internal documents.
The group will be seeking guidance from a committee that includes Philadelphia Department of Public Health Commissioner Dr. Tom Farley and David Jones, who is the commissioner of the city’s department of behavior health and Intellectual Disability Services. The city, however, will not be officially involved in the facility.
According to Goldfein, the organization has already raised $200,000, mostly from anonymous donors, to fund the supervised injection site —a facility she said will save lives and hopefully nudge more people into treatment.
Seattle, New York and San Fransisco are also considering opening a supervised injection site. Although 100 such sites operate worldwide, the United States has none.
Philadelphia, Goldfein said, might just be the first to officially open one.
“We recognize that there are many aspects of addressing the opioid epidemic and we can have an impact on one small piece,” Goldfein said Wednesday. “The thing we all know is you have to survive in order to get into treatment, so if we can keep people alive for one more day, then it’s one more day of a possibility that people will enter treatment and get their lives back.”
At the facility, participants will receive a physical and mental health assessment before being led to a room in which they can use the illegal drugs under the watch of medical professionals. They will be provided with fentanyl test strips — so they can see the makeup of their drugs — and clean equipment. After they use, they will be directed to another room where they can talk to staff members about social services, including housing needs and referrals to primary care.
Safehouse organizers say, “Philadelphia has a history of creative public health initiatives and prosecutorial discretion,” citing then-mayor Rendell’s move in the early 1990s, which health officials estimate helped drive down new HIV cases in the city more than 95 percent when comparing 1992 cases to the present day.
Back then, Rendell vowed to be the first arrested if authorities attempted to block the program. The threatened crackdown never happened.
With supervised injection facilities, the Kenney administration has taken a different approach: The city will not be formally involved, and no public money will be devoted to the facility. Yet city leaders support the effort.
“This might be a wiser path that Mayor Kenney is following, because I would get arrested before him,” Rendell said.
The ‘pursuit of good policy’
Rendell said he is now making calls to find a co-sponsor to assist with fundraising. He has identified several interested donors, including “a lawyer who’s got some means,” but he would not disclose the name of that person.
Rendell said the Trump administration promising to come down hard on the proposal just because it is technically illegal is misguided. He cited studies that have shown that in Vancouver and across Europe, supervised injection sites have driven down the rate of fatal overdoses and provided a bridge to treatment services.
Furthermore, Safehouse planners say federal anti-drug laws were “never intended to apply, and do not apply, to a nonprofit providing a good faith, public health approach to overdose prevention services,” including a supervised injection site, according to their internal memo.
In his interview with WHYY, Rosenstein indicated that he does not see it that way, saying, “I’m not aware of any valid basis for the argument that you can engage in criminal activity as long as you do it in the presence of someone with a medical license.” He cited federal drug laws that would prohibit such a site from operating.
Rendell, the former district attorney of Philadelphia and author of “A Nation of Wusses: How America’s Leaders Lost the Guts to Make Us Great,” said sometimes you have to ignore bad laws in order to pursue good policy.
“It’s easy to say, ‘It’s the law, I’m sorry, guys, I can’t do it. It’s the law. I’m sworn to uphold the law. Look, the history of this country is about change brought about by people having the courage to say, ‘this law makes no sense,’” Rendell said.